Factors associated with receipt of COVID-19 vaccination and SARS-CoV-2 seropositivity among healthcare workers in Albania (February 2021-June 2022): secondary analysis of a prospective cohort study.

COVID-19 Health care workers Risk SARS-CoV-2 Seropositivity Vaccination

Journal

The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 12 10 2022
revised: 23 12 2022
accepted: 03 01 2023
medline: 5 4 2023
entrez: 4 4 2023
pubmed: 5 4 2023
Statut: ppublish

Résumé

Healthcare workers (HCWs) have been disproportionally affected by COVID-19. We investigated factors associated with two- and three-dose COVID-19 vaccine uptake and SARS-CoV-2 seropositivity among 1504 HCWs enrolled (19 February-7 May 2021) in a prospective COVID-19 vaccine effectiveness cohort in Albania through a secondary analysis. We collected sociodemographic, occupational, health, prior SARS-CoV-2 infection, and COVID-19 vaccination data from all HCWs at enrollment. Vaccination status was assessed weekly through June 2022. A serum sample was collected from all participants at enrollment and tested for anti-spike SARS-CoV-2 antibodies. We analyzed HCWs characteristics and outcomes using multivariable logistic regression. By 11 June 2022, 1337 (88.9%) HCWs had received two COVID-19 vaccine doses, of whom 255 (19.1%) received a booster. Factors significantly associated with receiving three doses (adjusted odds ratio (aOR), 95% CIs) were being ≥35 years (35-44 years: 1.76 (1.05-2.97); 45-54 years: 3.11 (1.92-5.05); ≥55 years: 3.38 (2.04-5.59)) and vaccinated against influenza (1.78; 1.20-2.64). Booster dose receipt was lower among females (0.58; 0.41-0.81), previously infected (0.67; 0.48-0.93), nurses and midwives (0.31; 0.22-0.45), and support staff (0.19; 0.11-0.32). Overall 1076 (72%) were SARS-CoV-2 seropositive at enrollment. Nurses and midwifes (1.45; 1.05-2.02), support staff (1.57; 1.03-2.41), and HCWs performing aerosol-generating procedures (AGPs) (1.40; 1.01-1.94) had higher odds of being seropositive, while smokers had reduced odds (0.55; 0.40-0.75). In a large cohort of Albanian HCWs, COVID-19 vaccine booster dose uptake was very low, particularly among younger, female, and non-physician HCWs, despite evidence demonstrating the added benefit of boosters in preventing infection and severe disease. Reasons behind these disparities should be explored to develop targeted strategies in order to promote uptake in this critical population. SARS-CoV-2 seroprevalence was higher among non-physicians and HCWs performing APGs. A better understanding of the factors contributing to these differences is needed to inform interventions that could reduce infections in the future. This study was funded by the Task Force for Global Health (US Centers for Disease Control (CDC) cooperative agreement # NU51IP000873) and the World Health Organization, Regional Office for Europe

Sections du résumé

Background UNASSIGNED
Healthcare workers (HCWs) have been disproportionally affected by COVID-19. We investigated factors associated with two- and three-dose COVID-19 vaccine uptake and SARS-CoV-2 seropositivity among 1504 HCWs enrolled (19 February-7 May 2021) in a prospective COVID-19 vaccine effectiveness cohort in Albania through a secondary analysis.
Methods UNASSIGNED
We collected sociodemographic, occupational, health, prior SARS-CoV-2 infection, and COVID-19 vaccination data from all HCWs at enrollment. Vaccination status was assessed weekly through June 2022. A serum sample was collected from all participants at enrollment and tested for anti-spike SARS-CoV-2 antibodies. We analyzed HCWs characteristics and outcomes using multivariable logistic regression.
Findings UNASSIGNED
By 11 June 2022, 1337 (88.9%) HCWs had received two COVID-19 vaccine doses, of whom 255 (19.1%) received a booster. Factors significantly associated with receiving three doses (adjusted odds ratio (aOR), 95% CIs) were being ≥35 years (35-44 years: 1.76 (1.05-2.97); 45-54 years: 3.11 (1.92-5.05); ≥55 years: 3.38 (2.04-5.59)) and vaccinated against influenza (1.78; 1.20-2.64). Booster dose receipt was lower among females (0.58; 0.41-0.81), previously infected (0.67; 0.48-0.93), nurses and midwives (0.31; 0.22-0.45), and support staff (0.19; 0.11-0.32). Overall 1076 (72%) were SARS-CoV-2 seropositive at enrollment. Nurses and midwifes (1.45; 1.05-2.02), support staff (1.57; 1.03-2.41), and HCWs performing aerosol-generating procedures (AGPs) (1.40; 1.01-1.94) had higher odds of being seropositive, while smokers had reduced odds (0.55; 0.40-0.75).
Interpretation UNASSIGNED
In a large cohort of Albanian HCWs, COVID-19 vaccine booster dose uptake was very low, particularly among younger, female, and non-physician HCWs, despite evidence demonstrating the added benefit of boosters in preventing infection and severe disease. Reasons behind these disparities should be explored to develop targeted strategies in order to promote uptake in this critical population. SARS-CoV-2 seroprevalence was higher among non-physicians and HCWs performing APGs. A better understanding of the factors contributing to these differences is needed to inform interventions that could reduce infections in the future.
Funding UNASSIGNED
This study was funded by the Task Force for Global Health (US Centers for Disease Control (CDC) cooperative agreement # NU51IP000873) and the World Health Organization, Regional Office for Europe

Identifiants

pubmed: 37013112
doi: 10.1016/j.lanepe.2023.100584
pii: S2666-7762(23)00002-9
pmc: PMC9969343
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100584

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : NCIRD CDC HHS
ID : U38 IP000873
Pays : United States

Informations de copyright

© 2023 World Health Organization.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare that are relevant to the content of this article.

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Auteurs

Pernille Jorgensen (P)

World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark.

Alexis Schmid (A)

Boston Children's Hospital Global Health Program, Boston, MA, USA.

Jonilda Sulo (J)

Southeast European Center for Surveillance and Control of Infectious Diseases, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Iria Preza (I)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Iris Hasibra (I)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Esther Kissling (E)

Epiconcept, 25 Rue Titon, 75011, Paris, France.

Albana Fico (A)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Shela Sridhar (S)

Boston Children's Hospital Global Health Program, Boston, MA, USA.
Brigham and Women's Hospital, Department of Global Health Equity, 651 Huntington Avenue FXB, Building, 7th Floor, Boston, MA, USA.

Julia E Rubin-Smith (JE)

Boston Children's Hospital Global Health Program, Boston, MA, USA.

Majlinda Kota (M)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Adela Vasili (A)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Rovena Daja (R)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Miljana Nika (M)

Tirana University Hospital "Mother Theresa", Dibra Street N.372, 1001, Tirana, Albania.

Richard Pebody (R)

World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark.

Kathryn E Lafond (KE)

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Mark A Katz (MA)

World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark.

Silvia Bino (S)

Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania.

Classifications MeSH